Substance Abuse and BMI Are Associated with Increased Inflammation and Oxidative Stress in Participants of the Miami Adult Studies on HIV (MASH) Cohort

Abstract

Abstract Objectives Inflammation and oxidative stress are considered important factors in the development of non-communicable diseases with aging. We determined associations between body mass index (BMI), oxidative stress (OS), and inflammation in people living with HIV (PLWH) and un-infected substance users. Methods Overweight/obesity (OW/OB) was defined as BMI ≥ 25 and normal weight (NW) as BMI ≤ 24.9 in participants of the MASH cohort. Cocaine use was assessed with questionnaires and urine toxicology. Smoking was assessed with questionnaires. Blood was collected to assess inflammation (high sensitivity C-reactive protein [hsCRP] >3 m/L) by LabCorp, and OS with ARBOR ASSAYS (Ann Arbor, MI) glutathione colorimetric detection kit with %oxidized glutathione above median (>2.33%) as elevated. HIV viral load (VL) was obtained from medical charts. Regressions compared substance-abusing PLWH and un-infected people and controlled for age, sex, HIV status, and BMI. Results Mean age of the 605 participants was 54.4 ± 7.4 years, 54.7% male, 70.1% Black; 76% were OW/OB; 73% used cocaine and smoked cigarettes. PLWH comprised 45.5% of the population and 75% had suppressed VL. Regardless of HIV status, OW/OB cocaine users had higher odds for inflammation (OR = 3.1, 95% CI: 1.7–5.6, P < 0.001) and higher OS (OR = 2.0, 95% CI: 1.1–3.4, P = 0.018) than NW cocaine users. OW/OB cocaine + cigarette users also had higher odds for inflammation (OR = 2.6, 95% CI: 1.6–4.2, P = 0.001) and higher OS (OR = 1.9, 95% CI: 1.2–2.9, P = 0.006) than NW cocaine + cigarette users. There were no differences in inflammation or OS between OW/OB cocaine alone or with cigarette use and non-users (P = 0.707). HIV status was not independently associated with inflammation or high OS (P > 0.33). Conclusions These results indicated that OW/OB is associated with higher levels of inflammation and oxidative stress than normal weight even when accompanied with cocaine use as well as cocaine + cigarette use. These findings suggest that the use of substances does not increase inflammation or OS beyond overweight/obesity. In addition, in this cohort, with largely suppressed VL, HIV status was not independently associated with greater inflammation or OS. OW/OB is prevalent among PLWH and healthy people and may play an important role in the development of non-communicable diseases. Funding Sources National Institute on Drug Abuse.